Colm Keaveney (Galway East, Fianna Fail) | Oireachtas source

In December 2011, a briefing note was sent from the office of the then Minister of State with responsibility for the implementation of GP care. It details the sequencing of the introduction of the free GP scheme as originally intended. This was early in the lifetime of the Government and before electoral concerns came to the fore for the parties in government. The memorandum states that free GP care is to be phased in over the term of the Government.and that this would take place in four phases, after which everyone would be entitled to free GP care. The note goes on to argue that it would take four phases to allow for the financing of the initiative and the recruitment of more GPs and practice nurses. The first two phases were chosen on the basis that the numbers were known and were small enough and manageable.

Each of the phases is set out in the programme for Government and they are as follows:

Phase 1

The first phase will involve providing free GP care to claimants under the Long Term Illness Scheme.

Phase 2

The second phase will see free GP care extended to claimants on the High-Tech Drugs Scheme.

Phase 3

The third phase will involve extending subsidised GP care to everyone. There are a number of possible scenarios for this and these are being looked at. In particular, we would hope to use this phase to focus on preventative care, particularly for people with chronic health conditions.

Phase 4

The fourth phase will involve extending free GP care to all.

The note goes on to provide some points of clarification and states:

- Please note, only those people who qualify for the Long Term Illness Scheme and who are current claimants will benefit in the first year. This amounts to about 56,000 people. One of the main beneficiaries in the first year will be people with diabetes.

- The reform is scheduled for commencement around early Summer 2012, although this is subject to change. The reform will require legislation and there are a number of logistical elements that have yet to be worked out.

Almost three years have passed and the Government parties' original plan for rolling out the scheme has failed.

The briefing note to which I refer went on to provide further clarification on how the scheme would operate, including information on the medical conditions that would be covered in phase 1. They include: mental handicap; mental illness; diabetes; haemophilia; cerebral palsy; epilepsy; cystic fibrosis; multiple sclerosis; spina bifida; muscular dystrophy; acute leukaemia; and conditions arising from use of Thalidomide. As can plainly be seen, the original intention behind this worthy scheme which Fianna Fáil supports was to roll it out by prioritising on the basis of need and leaving those of us who are generally healthy until last. Sadly and in response to increasing electoral imperatives, the Government lost the will to roll out the scheme in a fair and just manner. Instead, it decided to prioritise the rolling out of the scheme on the basis of where the greatest electoral gain might be achieved. This resulted in the announcement in recent days of an agreement with one of the GP representative bodies to extend free GP cards to those under six years of age. This will provide free GP care for all children under six years, while children who are seven or eight years of age and suffering from long-term illnesses will be denied such care. I genuinely see universal GP care as potentially being a great step forward in the area of public health and want it to be implemented. However, I cannot understand why the Government proceeded to introduce it in the way I have outlined.

Many of those who are in dire need of care and languishing on waiting lists are questioning the Government's policy in this area. The scheme should have been rolled out in the way that was originally intended, namely, with those in greatest medical need being prioritised. Legal concerns have been cited as an explanation as to why the Government decided to proceed in the way to which I refer. However, that explanation is insufficient. What does a parliament do? The answer is that it creates laws. If there are legal concerns about or impediments to the roll-out of long-term illness cards, the place to take action and solve any problem is in these Houses. Shortly after sending the briefing note from which I have quoted, the Minister of State concerned felt compelled to step down from her position on a matter of principle in another area of public health policy. Once she was gone, the political will to implement policy on long-term illness cards in a fair and just manner was lost.

The Bill before the House involves the extension of the scheme to those over 70 years who currently do not qualify for long-term illness cards. Approximately 36,000 will gain from this measure. I welcome this aspect of the Bill and look forward to supporting it, as we should provide for some ease of comfort and security for senior citizens. The Government no doubt hopes the Bill will buy it some forgiveness from the elderly for the series of attacks to which it has subjected them during its term of office to date. Deputies opposite should be aware that elderly people will not forget and that they are not prone to forgive. Only two years ago, the Government brought forward legislation to take medical cards from the over 70s.

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